Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, No. 253, Central Industrial Road, Guangzhou, Guangdong 510282, China.
Chin Med J (Engl). 2010 May 5;123(9):1149-53.
With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery.
Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.
The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.
Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.
随着计算机技术的飞速发展，数字医学已成为外科的一个新方向。数字医学在肝外科中的应用仍处于早期阶段，文献报道较少。本研究旨在将数字医疗技术应用于肝外科领域。
将 17 例患者（其中肝细胞癌 13 例，肝血管瘤 4 例）的 64 层螺旋 CT 数据导入自主开发的医学影像软件程序，进行分割和三维重建。然后使用 FreeForm Modeling System 对三维模型进行处理。我们使用虚拟手术器械对模型进行手术。模拟手术包括 6 例肝段切除术、4 例左半肝切除术、3 例肝细胞癌右半肝切除术、1 例肝段切除术、2 例剥离术和 1 例不规则肝段切除术联合剥离术。对于涉及超过 3 个肝段的切除，在模拟手术前后测量全肝和剩余功能性肝体积，并计算切除率。
模型解剖结构清晰，可用于定位病变。我们使用虚拟手术器械进行模拟手术，并使用模型优化实际手术。我们能够最小化切除体积和手术风险。
数字医学技术有助于肝脏疾病的诊断和手术方案的优化。三维模型可以降低手术风险，有助于预防术后肝衰竭。
